温阳通腑降浊法治疗慢性肾衰竭阳虚浊毒证疗效观察

采用温阳通腑降浊法治疗阳虚浊毒证慢性肾衰竭（CRF）患者30例,并随机与对照组30例进行比较,治疗组显效率和总有效率均优于对照组（P＜0．05）,治疗组对改善患者症状优于对照组,肾功能指标测定,治疗组在增加Ccr、降低Scr方面优于对照组（P＜0．05）,远期疗效观察亦表明治疗组对延缓慢性肾衰竭的进展优于对照组（P＜0．01）。提示温阳通腑降浊法是治疗阳虚浊毒型慢性肾衰竭有效的治疗方法。     

中药灌肠治疗慢性肾衰竭96例疗效观察

目的:探讨中药灌肠对慢性肾衰竭(CRF)的临床疗效及延缓CRF进展的作用机制.观察中西医多途径联合治疗慢性肾衰竭早、中期的临床疗效.方法:将96例CRF患者随机分为治疗组和对照组各48例.治疗组在西医治疗基础上加用中药灌肠治疗;对照组以一般西医常规治疗,观察2组临床疗效及治疗前、后的肾功能变化,并进行比较.结果:治疗组显效率37.5%,总有效率85.4%,对照组分别为16.6%,52.08%,治疗组明显高于对照组,两组总有效率比较差异有显著性(P＜0.01);治疗组血肌酐(Cr)、尿素氮(BUN)、肌酐清除率(Ccr)改善均优于对照组(P＜0.01).结论:中西医多途径联合治疗慢性肾衰竭,其疗效明显,保护肾功能,从而延缓肾衰竭的发展.     

药浴治疗慢性肾衰竭78例临床观察

笔者自2009年起与南京中医药大学合作,精心选用疏通腠理、温阳散寒等中药进行药浴治疗慢性肾衰竭(CRF),取得较好疗效,总结如下。临床资料.1一般资料本组78例,男45例,女33例;年龄2~55岁;病程3个月~5年。慢性肾小球肾炎40     

慢性肾衰竭合并上消化道黏膜病变的临床治疗

目的探讨慢性肾衰竭（CRF）并发上消化道黏膜病变的有效治疗方法。方法对42例CRF并发上消化道疾病患者和40例非CRF的上消化道疾病患者进行胃镜检查了解黏膜病变;随机对照研究麦滋林-S颗粒辅助治疗的临床疗效。结果CRF患者的上消化道症状与黏膜病变均较重,麦滋林-S结合泮托拉唑治疗20d后临床症状改善,胃镜下表现及病理组织学等方面均有不同程度的好转,发现麦滋林-S治疗组的治疗效果较对照组在CRF患者中有显著疗效（P〈0．05）。结论CRF患者上消化黏膜病变较重,麦滋林-S结合泮托拉唑治疗具有显著疗效。     

疾病与营养系列讲座--慢性肾衰竭的营养治疗

慢性肾衰竭(CRF)是指各种慢性肾脏病晚期,肾实质已严重毁损,致使氮质代谢产物潴留,水、电解质及酸碱平衡失调,内分泌紊乱等所表现的一种临床症候群.CRF时存在营养代谢障碍,可进一步加重肾功能损害.营养不良是接受血液透析老年患者病死率增加的危险因素[1].因此,CRF的营养治疗能有效地配合药物治疗,能延缓肾功能恶化及减轻患者经济负担.     

调畅三焦气机法阻断慢性肾衰竭渐进性发展临床研究

目的 探讨调畅三焦气机法阻断慢性肾衰竭渐进性发展的效果.方法 选择我院于2015年6月—2016年6月期间收治的60例慢性肾衰竭患者作为研究对象,随机分成2组,观察组与对照组各30例.对照组采用常规治疗,观察组采用调畅三焦气机法治疗,比较2组治疗效果、肾功能、尿常规,以彩色多普勒超声观察肾脏大小、肾实质改变情况.结果 观察组近期、远期治疗效果均优于对照组,差异有统计学意义(P<0.05);治疗后与对照组相比,观察组肾小球滤过率升高,尿隐血改善,尿蛋白、红细胞水平降低,差异有统计学意义(P<0.05);治疗后,观察组肾脏厚径、长径、实质厚度及宽径均低于对照组,差异有统计学意义(P<0.05).结论 慢性肾衰竭患者采用调畅三焦气机法治疗能够阻断病情渐进性发展,防止肾功能进一步恶化,且治疗效果显著优于常规治疗,值得临床广泛应用.     

慢性肾衰竭的中医药治疗进展

慢性肾衰竭(CRF)是指发生在各种慢性肾脏疾病后期的一种临床综合征.CRF是临床常见病、多发病,病情危重,严重危害患者的健康甚至生命.一旦肾功能损害发生后,其损害的进展均呈进行性恶化,直至发展为终末期肾功能衰竭.如何对CRF进行早期预防,延缓CRF病程的发展,已成为各国关注的问题.     

温阳活血方对慢性肾脏病2～3期阳虚血瘀型患者疗效观察

目的:观察温阳活血方治疗慢性肾脏病(CKD)2~3期阳虚血瘀型患者的临床疗效。方法:将60例CKD 2~3期阳虚血瘀型患者随机分为治疗组和对照组,各30例,对照组给予西医对症治疗,治疗组在对照组治疗基础上加用温阳活血方,治疗12周后观察2组临床疗效、肾功能和蛋白尿等变化情况。结果:温阳活血方可以改善治疗组的临床症候,降低血Scr、BUN水平,降低蛋白尿,与对照组比较差异有统计学意义(P<0.05)。结论:温阳活血方可以有效延缓CKD 2~3期阳虚血瘀型患者肾功能进展,改善患者临床症状,临床安全有效。     

慢性肾衰竭临床分期与左心结构及功能的相关性分析

目的 探讨慢性肾衰竭(CRF)患者临床各期与左心结构及功能的相关性,为临床防治继发性心脏疾病提供依据.方法 选取90例CRF患者进行临床分期,测定心脏彩超相关的指标,对检测结果进行统计分析.结果 CRF患者的Tei指数从代偿期→失代偿期→肾衰竭期→尿毒症期,逐渐增大(P＜0.01);随着的病程进展,IVSd逐渐增厚;左...     

CyPA与慢性肾衰竭相关性及作用研究

目的 研究亲免素A （CyPA）在正常人及慢性肾衰竭（CRF）患者外周血中的浓度水平变化,明确CyPA是否与慢性肾衰竭有关联性及可能的作用机制.方法 CRF患者及正常人对照组各50例,采用ELISA法分别测定（1）正常人外周血CyPA,同时测定AngⅡ、、TNFα、IL-6、IL-1α、单核细胞趋化蛋白（MCP-1）。（2）慢性肾衰竭患者厄贝沙坦治疗前抽取外周血测定CyPA,AngiⅡ、TNFα、IL-6、IL-1α、单核细胞趋化蛋白（MCP-1）水平.治疗1月后再次抽取外周血测定外周血CyPA,AngⅡ、TNFα、IL-6、IL-1α、单核细胞趋化蛋白（MCP-1）水平.比较组间差异及分析CyPA与CRF的相关性及CyPA与AngⅡ、TNFα、IL-6、IL-1α、MCP-1等炎性因子的关联性.结果 （1） CRF组外周血CyPA水平治疗前后均高于健康对照组; （2）在CRF组与正常对照组中,外周血CyPA水平与AngⅡ、TNFα、IL-6IL-1α、MCP-1等存在组间差异（P＜0.01）; （3）经spearman相关分析,在对照组中,慢性肾衰竭治疗前,及慢性肾衰竭氯沙坦治疗后,CyPA均与AngⅡ及TNFα、IL-6、IL-1α、MCP-1有相关性.结论 CyPA可能与AngⅡ协同作用,增加炎性细胞因子趋化水平,促进了CRF患者炎性反应,加重肾小球、肾小管及间质损伤.炎症反应是慢性肾衰竭加速进展的重要原因之一。通过选择性的抑制CyPA或阻断CyPA受体可能为我们提供了一条新的可供选择的治疗途径。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.